Diagnostic value of magnifying endoscopy with blue laser imaging for early esophageal cancers / 中华消化内镜杂志

ABSTRACT

Objective To evaluate the magnifying endoscopy with blue laser imaging( M-BLI) for early esophageal cancers. Methods A total of 153 focal esophageal lesions detected with conventional white light endoscopy (WLE) based on changes of mucosal shape and color were enrolled in this study. Patients were examined with WLE, M-BLI, and 1. 25% Lugol′s iodine chromoendoscopy between April 2015 and December 2016. Diagnostic consistency of M-BLI and Lugol′s iodine chromoendoscopy were evaluated with pathology as a golden standard. Results Pathological diagnosis showed there were 19 lesions of esophagitis or chronic mucosal inflammation,92 of low grade intraepithelial neoplasia,and 42 high grade intraepithelial neoplasia or early cancer. Diagnostic sensitivities of WLE, M-BLI and Lugol′s iodine chromoendoscopy of screening early cancer were 66. 7%( 28/42 ), 95. 2%( 40/42 ), and 95. 2%( 40/42 ) respectively, the specificities were 57. 7%( 64/111 ), 91. 9%( 102/111 ), and 92. 8%( 103/111 ) respectively. The consistency rate between endoscopy and pathological examination were 60. 1%( 92/153 ), 92. 8%(142/153), and 93. 5%(143/153) respectively,and the Kappa values were 0. 565, 0. 891, and 0. 906 respectively. The detection rate of M-BLI was higher than that of WLE alone ( χ2 ＝9. 166, P＝0. 002). Conclusion The diagnostic value of M-BLI for early esophageal cancer is similar to that of Lugol′s iodine chromoendoscopy. However, M-BLI is easier to operate, and superior to Lugol′s iodine staining endoscopy in the absence of iodine allergy, long operating time and patients′intolerance.